About The Auctus Group LLC
Who we are: We’re big on people and culture at the Auctus Group.
Our most important role as a company is to provide an amazing working environment for our team.
We’ve been work-from-home warriors since before it was cool.
We support continuing education and match charitable donations.
Our whole goal is: work to live not live to work.
We’re also known for remote happy hours, a book club, and other lighthearted activities.
Who we’re looking for
- Smart, talented, tech-savvy, experienced, go-getter types.
- You’ll do well if you like a fast-paced environment, thrive with change and development, enjoy giving feedback, are a team player, love learning/sleuthing, and are big on accountability.
About The Role
- Responsible for interpreting and analyzing coded services provided utilizing standardized medical coding to ensure that all claims billed and collected meet government or funder mandated procedures for accuracy, integrity, and compliance.
- Review and apply modifiers, spot CPT mismatches based on NCCI edits, recognize fee schedule reimbursement structures related to modifiers and CPTs, and recommend changes.
Coding from operative notes is not required, though the skillset is favored.
- Submit paper and electronic billing timely to various payers in accordance with contract requirements, including corrections, adjustments, rebilling, and proper modifications to claims per billing procedures.
- Review rejected claims and research contract guidelines to ensure corrections and adjustments are worked and resolved timely, generally within 48 hours of receipt, with an actionable step toward payment each month for each claim.
- Coordinate with The Auctus Group team to obtain information relevant to rejected or denied claims, account onboarding, and training needs.
Maintain current knowledge of governmental, funder, contractor mandated regulations or payer requirements related to claims submissions.
- Provide continuous updates to management regarding ongoing errors, payer-related issues, registration issues, and other QA activities affecting reimbursement.
Trends are escalated to Revenue Cycle Managers and Team Leads weekly.
- Maintain HIPAA confidentiality at all times.
Perform other duties as assigned.
Qualifications
- Strong problem-solving skills with the ability to identify and address issues effectively.
- Excellent organizational skills with the ability to set priorities, work independently, and collaborate with diverse teams.
- Proven ability to work effectively as a team player with a collaborative and solution-oriented approach.
- Strategic and proactive mindset, with the ability to anticipate challenges and drive improvements.
- Proficiency in computer systems with a strong interest in learning and adapting to new technologies.
- Knowledge of medical terminology and revenue cycle processes (including insurance verification, billing, collections, cash posting, and coding) is preferred.
- Strong verbal and written communication skills in English; bilingual proficiency is a plus.
- Ability to multitask and thrive in a fast-paced environment.
- Availability to work full-time during standard business hours, with flexibility for additional hours as needed.
- Ability to maintain professionalism, confidentiality, and productivity while working remotely.
Required Education And Experience
- 1-3+ years of medical billing experience.
- Ideally in a multi-entity healthcare organization.
- Candidates must have a reliable computer and high-speed internet to perform job duties in a remote work environment.
- Familiarity with Electronic Health Records (EHR).
- Experience with clearinghouse software.
- Plastic Surgery and/or Dermatology billing is a plus.
Physical Demands
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Regularly required to sit and talk or hear.
- Regularly required to use a computer keyboard and mouse.
- Frequently required to use hands, handle, or feel; reach with hands and arms.
- Specific vision abilities required include close vision, peripheral vision, depth perception, and the ability to adjust focus.
Work Environment
This job operates in a remote office environment.
This role routinely uses standard office equipment such as computers, phones, and other typical tools.
Seniority level
Employment type
Job function
- Accounting/Auditing and Finance
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